Individual provider Active NPI

Mynette Shifman, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Westborough, MA
National Provider Identifier
1922081124
Registry record updated Jun 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
226216 Issued in MA
Practice address
125 Turnpike Rd Ste 5
Westborough, MA 01581-2841
Phone
(508) 595-8181
Fax
(508) 219-6521
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 226216 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 226216 MA Primary

Addresses

Primary practice location

125 Turnpike Rd Ste 5
Westborough, MA 01581-2841

Mailing address

125 Turnpike Rd Ste 5
Westborough, MA 01581-2841
Phone (508) 595-8181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
226216MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lasell College Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751068800000",
    "number": "1922081124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 TURNPIKE RD STE 5",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015812841",
            "telephone_number": "508-595-8181",
            "fax_number": "508-219-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 TURNPIKE RD STE 5",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015812841",
            "telephone_number": "508-595-8181",
            "fax_number": "508-219-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFMAN",
        "first_name": "MYNETTE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2025-06-28",
        "certification_date": "2025-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "226216",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "226216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.